Clinical relevance of lymph node ratio in resected oral cavity squamous cell carcinoma in patients with N2 disease.
Bibliographic record
Abstract
6019 Background: Lymph node ratio (LNR, number of positive lymph nodes/total number of excised lymph nodes) has been shown to be associated with outcomes in multiple malignancies. In this study, the impact of LNR on distant metastasis (DM) and overall survival (OS) in oral cavity squamous cell carcinoma (OSCC) was investigated. Methods: Retrospective review of pN0-2 OSCC patients (pts) treated between 1994-2012 with curative surgery with neck dissection (ND) +/- postoperative radiotherapy (PORT) with or without concurrent chemotherapy (CCT). LNR was subjected to multivariable analysis (MVA) of DM and OS, adjusted for pT3-4, extracapsular extension (ECE), high grade (G3), lymphovascular invasion (LVI), perineural invasion (PNI), and tumor subsite. Results: Overall 914 pts were identified; median age: 61 yr (18-92); median follow-up: 51 months (1–189); pT3-4: 283 (31%); pN-classification: N0: 482 (53%), N1: 128 (14%), N2a: 6 (0.5%); N2b: 225 (24.5%); N2c: 73 (8%); median number of dissected nodes: 36 (6-125); median number of pN+: 2 (1-49); median LNR for pN+ pts: 0.06; ECE: 187 (20%); G3: 147 (16%); LVI: 115 (13%); PNI: 416 (46%). Bilateral ND was performed in 367 (40%); PORT was used in 452 (49%); and CCT in 80 (9%). The 5-yr distant control (DC) and OS were 89% and 70%; respectively. pT3-4 (p<0.001), G3 (p<0.001), LVI (p=0.0013), and PNI (p<0.001) were all associated with high LNR. On MVA, LNR >0.06 was associated with more DM (HR=1.8; 95%CI=1.1-3.1; p=0.017) and lower OS (HR=2; 95%CI=1.4–2.8; p<0.001). In subgroup analysis of pN2 pts (n=304): higher LNR (>0.14) was associated with lower 5yr- DC (67%, p=0.014) and OS (25%, p<0.001), and on MVA within the pN2 subgroup, both higher LNR (p<0.001) and ECE (p=0.006) were associated with lower OS. Conclusions: High LNR is associated with higher rate of DM and lower OS in OSCC. LNR should be assessed in pN2 pts in future prospective trials to select patients for adjuvant therapies.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".